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Biomedical subjects

G Smith

Publications and source records attributed to G Smith.

At least 559 records · Page 31Linked to original sources
PubMed1990

The first two years' experience with major trauma at a pediatric trauma center.

We reviewed the records of 233 patients with major trauma admitted to The Children's Hospital of Alabama during the first 2 years of operation of its Pediatric Trauma Center. The male-to-female ratio was 1.7:1. The highest incidence of trauma occurred in the spring (88 patients, 38%) and the lowest in the winter (36 patients, 15%). Most children (184, 79%) were injured between noon and midnight. Blunt mechanisms of injury accounted for 206 patients (88%), penetrating for 17 (7%), and burns for ten (4%). The distribution of injuries by organ system was head/neurologic, 185 patients (79%); musculoskeletal, 83 (36%); thoracic, 57 (24%); abdominal, 29 (12%); major soft-tissue, 26 (11%), genitourinary, 11 (5%); and vascular, 11 (5%). Surgery was required at some point during the hospitalization in 89 patients (38%). Seventy-two patients (31%) experienced 115 complications. The mean length of time spent for resuscitation and stabilization in the trauma room was 49 min. The mean ICU stay was 3.2 days. Total length of hospitalization averaged 11.2 days. Twenty-six patients (11%) died. The Pediatric Trauma Score and the Pediatric Coma Score were found to be predictive of outcome. The organization and function of the trauma team is described, and public health concerns are discussed.

Adolescent↗
PubMed1990

Males as a high-risk group for trauma: the Finnish experience.

The high incidence of trauma among young men has been observed in many countries. To better understand this risk, we analyzed male injuries and their causes in Finland. The incidence peak of medically attended trauma in men aged 15-24 years was caused by occupational and sports injuries, whereas that of hospitalizations was due to motor vehicle injuries. Age patterns of nonfatal trauma resembled those recorded in the U.S.A. However, patterns and causes of fatal trauma were very different in the two countries: early adulthood in the U.S.A. and late middle-age in Finland were the ages of highest injury mortality. The majority of deaths in young men were caused by motor vehicle injuries in the U.S.A., whereas suicides and the extremely high rate of fatal non-motor vehicle accidents, largely due to alcohol poisoning and drownings, formed the main bulk of injury mortality in Finland. Similarities in early adulthood suggest general biological factors, whereas the deviance of the middle-aged male Finns from the general pattern may indicate more specific psychosocial factors.

Adolescent↗
PubMed1990

The NAP prism.

The optics of the NAP prism are described. This is a prism that is produced commercially in "NAP glasses," which are marketed by the Sakura Company of Japan. It deflects a beam through about 90 degrees while keeping the image erect. Rays are both reflected and refracted, leading to some color fringing. The condition for zero color fringing is explored and the corresponding angle of deviation is calculated. The effects of prism apex angles on beam deviation angle and field of view are also investigated. The results show that the requirement for zero color fringing gives a small field of view but if some color fringing is tolerated, a larger field of view can be obtained.

Eyeglasses↗
PubMed1990

Changes in haemodynamics and plasma catecholamine concentrations after field block for inguinal herniorrhaphy using lignocaine with adrenaline.

Haemodynamic changes and plasma catecholamine concentrations were measured in 12 patients aged 24 to 87 years after performance of a field block for elective repair of inguinal or femoral hernia. The local anaesthetic used comprised a mixture of lignocaine 0.5% with adrenaline 1:200,000; the dose of lignocaine administered varied from 3.8 mg/kg to 4.9 mg/kg. Plasma adrenaline increased by 326% and plasma noradrenaline by 75% at 10 minutes after completion of the block. Mean heart rate increased from 75 to 94 beats/minute after 20 minutes, whilst there were no obvious changes in systolic and diastolic arterial pressures. Potentially serious arrhythmias developed in two patients, thought to be related to the peak plasma concentrations of adrenaline produced. It is recommended that the dose of adrenaline used as described for this block should be reduced.

Adult↗
PubMed1990

Motorcyclist traffic accidents and risk factors: a Singapore study.

Motorcyclist accidents cause significant morbidity and mortality in Singapore. To elucidate personal and environmental factors associated with such accidents, we studied 198 motorcyclists who were hospitalized in Singapore General Hospital between April 1986 and June 1987. The patients were mostly young and almost exclusively male with a high proportion of Malays. Most accidents occurred on Sundays and at night. Ten percent of the victims took alcohol before the accident. Most had low injury severity scores (ISS). Less experienced drivers had a significantly higher ISS than those with one year or longer of driving experience. Vigorous control of drunken driving, through public education and intensive breath testing, should reduce the incidence of traffic accidents.

Accidents, Traffic↗
PubMed1990

[Priorities and treatment principles in maxillofacial trauma].

The outline of therapeutic priorities in case of maxillo-facial traumatism may be divided in three different stages according to the need of acute urgent, urgent and necessary intervention. Acute urgent therapy is called for when the bleeding of the arteria carotis externa or the maxillary artery cannot be quenched or when the superior airways are obstructed by the soft tissues of the tongue or the floor of the mouth. A description of the therapeutic attitude in such cases is given. Urgent therapy should be given within 8 hours after the accident and mostly consists in the immobilisation of bony injuries and definite care of soft tissue lacerations. Necessary therapy includes the final surgical treatment such as osteosynthesis by titanium mini-plates. More specific problems like frontobasal fractures and fractures of the orbital floor are described separately.

Combined Modality Therapy↗
PubMed1990

Population biology of pseudorabies in swine.

A deterministic mathematical model of the population biology of pseudorabies in swine was used to clarify some of the basic features of the host-virus relationship and to inquire into the circumstances that promote or impede virus persistence in a single herd. When the basic reproductive rate of the infection (ie, the number of secondary infections resulting from the introduction of a single infective animal into a wholly susceptible herd) is greater than unity, the model suggests that the number of infective individuals in the herd will undergo highly damped oscillations to a final equilibrium level. The most important determinants of virus persistence are herd size and the density at which sows are maintained. There is a threshold density of susceptible individuals below which the virus will eventually be eliminated from the herd, even when specific control measures are lacking. Test and removal strategies hasten virus elimination when herd density is already below threshold, but are otherwise likely to succeed only when the removal of latent infections reduces the basic reproductive rate of the infection below unity. Vaccination strategies may also result in virus elimination, but only in relatively small herds.

Animals↗
PubMed1990

Open fractures of the tibia in children.

Forty-one children who had forty-two open fractures of the tibial metaphysis or diaphysis were studied retrospectively. Twelve fractures were Type I; eighteen, Type II; six, Type IIIA; four, Type IIIB; and two, Type IIIC, according to the classification of Gustilo et al. All fractures were irrigated and debrided, and antibiotics were given for a minimum of forty-eight hours after the injury. Twenty fractures were initially treated with external fixation and twenty-two, with immobilization in a plaster cast. Three patients had an early infection of the wound, one of which was associated with osteomyelitis; all were successfully treated. The average time to healing of the fracture was five months (range, two to twenty-one months). The time to union was related to the severity of the soft-tissue injury, the pattern of the fracture, the amount of segmental bone loss, the occurrence of infection, and the use of external fixation. There were six delayed unions. Four patients had an angular malunion of more than 10 degrees, which spontaneously corrected in three. One patient who had a proximal metaphyseal-diaphyseal segmental fracture had a progressive valgus deformity. Four patients who had a severe fracture that was treated with external fixation had more than one centimeter of tibial over-growth. There were no amputations. The incidences of compartment syndrome, vascular injury, infection, and delayed union were similar to those reported for open tibial fractures in adults.

Anterior Compartment Syndrome↗
PubMed1990

Mathematical model for the impact of a pseudorabies epizootic on the productivity of a farrow-to-finish operation.

A fully age-structured deterministic model of the population biology of a pseudorabies epizootic in a farrow-to-finish operation was used to examine the disease-related change in productivity following the initial disease episode. A strategy involving continual sow vaccination was compared with various strategies involving the vaccination of growing pigs, as well as sows. The model suggests that vaccinating growing pigs, in addition to the breeding herd, results in only a relatively small improvement in long-term productivity following a pseudorabies epizootic.

Animal Husbandry↗
PubMed1990

The aspherizing of intra-ocular lenses.

While a spherically surfaced intra-ocular lens cannot be designed to give zero spherical aberration for the whole eye, aspherizing one surface of an intra-ocular lens can produce zero Seidel spherical aberration in a pseudophakic eye or set it to any desired level provided the corneal asphericity is known and this does not change with the operation. Equations for determining the asphericities are given. Asphericities for five lens shapes; the minimum spherical aberration lens and its reverse form, the equi-biconvex lens, the plano-convex lens and its reverse form are determined. The Seidel aberrations of eyes with aspherized intra-ocular lenses were compared with that of eyes with spherical intra-ocular lenses. While aspherizing eliminates the Seidel spherical aberration, some residual higher order spherical aberration exists and the amount of this residual spherical aberration depends upon the lens shape. However, this residual aberration can be reduced but not made zero by modifying the asphericity. For currently used plano-convex lenses, only the curves surface can be aspherized. The effect of variations in the anterior corneal asphericity on the necessary lens asphericity was also investigated.

Cornea↗
PubMed1989

The nucleotide sequence of a mouse renin-encoding gene, Ren-1d, and its upstream region.

The renin-encoding genes have been cloned from high (Ren-1d, Ren-2d)- and low (Ren-1c)-renin-producing strains of mice (DBA/2J and C57BL/10). Each of the genes is approx. 9.6 kb in length and consists of nine exons and eight introns. The entire nucleotide sequence of the Ren-1d gene has been determined and the 5'-flanking regions of the three genes, Ren-1c, Ren-1d and Ren-2d, have been compared. The significance of several potential regulatory signals found in the DNA is discussed.

Amino Acid Sequence↗
PubMed1989

Treatment of sepsis in patients with neoplastic diseases with intravenous ciprofloxacin.

Hospitalized patients with sepsis caused by ciprofloxacin-susceptible organisms were treated with intravenous ciprofloxacin 300 mg every 12 hours. Patients were followed closely for side effects and adverse reactions as well as for their response to therapy. Culture specimens and laboratory parameters including serum chemistry profile, complete blood cell count, and urinalysis were obtained before, during (every four to five days), and after ciprofloxacin therapy. Antimicrobial susceptibility of bacterial isolates was determined by the microtiter technique. Patients were considered to have had a successful outcome if satisfactory improvement in signs and symptoms of infection occurred as well as bacteriologic cure, such as eradication of organisms from the blood during and after treatment. Of 30 septic episodes in 30 patients, 27 episodes were considered evaluable. Two septic episodes occurred in patients who were neutropenic (absolute neutrophil count less than 1,000/mm3). The sources of the 27 septic episodes were intra-abdominal (12 patients), indwelling intravenous access devices (11 patients), urinary tract (three patients), and skin/soft tissue (one patient). Of the 27 evaluable episodes, 24 (88.9 percent) had a completely successful outcome; three (11.1 percent) had a partially successful outcome. Partial successes included the occurrence of a Klebsiella pneumoniae reinfection in one patient, superinfection with Listeria monocytogenes in another patient with the concurrent development of a highly ciprofloxacin-resistant K. pneumoniae, and the recovery of a ciprofloxacin-resistant Pseudomonas aeruginosa during therapy in a third patient who also had superinfection due to Candida albicans. There were minimal ciprofloxacin-related adverse reactions and side effects. Although ciprofloxacin was generally well tolerated with minimal side effects and adverse reactions and was efficacious in the treatment of serious septicemic infections caused by gram-negative aerobic bacilli, the development of a resistant K. pneumoniae and the recovery of a resistant P. aeruginosa during therapy in two cases are of concern and deserve further investigation.

Adult↗